Pub Date : 2025-07-17DOI: 10.1016/j.jpag.2025.07.003
Cristina Villena MD , Carolyn D Brookhart MDMPH , Kirsten Das MD , Swetha Naroji MD , Veronica Gomez-Lobo MD
Background
46XY Complete Gonadal Dysgenesis (CGD), also known as Swyer syndrome, is characterized by nonfunctional streak gonads and an increased risk of gonadal neoplasms. While spontaneous puberty is not expected, hormonally active gonadal tumors can mimic normal puberty delaying diagnosis.
Case Presentation
We present two adolescents with 46XY CGD and tumor-driven puberty: a 16-year-old with spontaneous thelarche and adrenarche found to have a left gonadoblastoma, and a 14-year-old with spontaneous menarche and pelvic pain who was subsequently diagnosed with a dysgerminoma and a sex cord tumor with annular tubules (SCTAT).
Discussion & Conclusion
Puberty in patients with 46XY CGD should prompt suspicion for gonadal tumors. Early recognition and gonadectomy are crucial to prevent malignant transformation and optimize outcomes.
{"title":"Pubertal Development as a Marker of Gonadal Neoplasm in 46XY Complete Gonadal Dysgenesis","authors":"Cristina Villena MD , Carolyn D Brookhart MDMPH , Kirsten Das MD , Swetha Naroji MD , Veronica Gomez-Lobo MD","doi":"10.1016/j.jpag.2025.07.003","DOIUrl":"10.1016/j.jpag.2025.07.003","url":null,"abstract":"<div><h3>Background</h3><div>46XY Complete Gonadal Dysgenesis (CGD), also known as Swyer syndrome, is characterized by nonfunctional streak gonads and an increased risk of gonadal neoplasms. While spontaneous puberty is not expected, hormonally active gonadal tumors can mimic normal puberty delaying diagnosis.</div></div><div><h3>Case Presentation</h3><div>We present two adolescents with 46XY CGD and tumor-driven puberty: a 16-year-old with spontaneous thelarche and adrenarche found to have a left gonadoblastoma, and a 14-year-old with spontaneous menarche and pelvic pain who was subsequently diagnosed with a dysgerminoma and a sex cord tumor with annular tubules (SCTAT).</div></div><div><h3>Discussion & Conclusion</h3><div>Puberty in patients with 46XY CGD should prompt suspicion for gonadal tumors. Early recognition and gonadectomy are crucial to prevent malignant transformation and optimize outcomes.</div></div>","PeriodicalId":16708,"journal":{"name":"Journal of pediatric and adolescent gynecology","volume":"38 6","pages":"Pages 743-746"},"PeriodicalIF":1.8,"publicationDate":"2025-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144667854","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-07-16DOI: 10.1016/j.jpag.2025.07.002
Taryn Wassmer MD , Rama S. Ayyala MD , Katherine N. Epstein MD , Lesley Breech MD
Study Objective
Ultrasound (US) is the gold standard for evaluation of pelvic organs; however, achieving a full bladder can be challenging for children. Recent studies have shown excellent diagnostic performance of rapid MRI for acute appendicitis. As MRI becomes more prevalent in the evaluation of right lower quadrant pain, its use for gynecologic indications should be reevaluated.
Methods
A retrospective review of patients who had rapid MRI examinations performed in the emergency department (ED) for right lower quadrant pain at a single institution was conducted from August 2022 through August 2023. A time-matched control group with US evaluation for the same indication was obtained. A rapid, non-contrast three-sequence free-breathing MRI protocol was utilized.
Results
Of the 376 rapid MRI exams performed for the indication of right lower quadrant pain, 49 were noted to have gynecologic pathology identified. Of the 250 time-matched US controls, 51 were noted to have gynecologic pathology. The median MRI scan time (first image to last image) was 10 minutes. The total length of stay in the ED was significantly shorter in the rapid MRI group than in the controls (median 338 minutes vs 442 minutes, P < .05). Time to imaging diagnosis was significantly shorter in the rapid MRI group (201 minutes vs 285 minutes, P < .01). Time to gynecology consultation was not significantly different between groups (238 minutes vs 253 minutes, P = .66).
Conclusion
First-line, rapid MRI for evaluation of gynecologic processes can provide imaging diagnoses faster than using US and results in lower overall lengths of stay in the ED.
{"title":"Rapid, Free-Breathing Non-Contrast MRI for Evaluation of Gynecologic Pathologies in the Emergency Department: A Retrospective Cohort Study","authors":"Taryn Wassmer MD , Rama S. Ayyala MD , Katherine N. Epstein MD , Lesley Breech MD","doi":"10.1016/j.jpag.2025.07.002","DOIUrl":"10.1016/j.jpag.2025.07.002","url":null,"abstract":"<div><h3>Study Objective</h3><div>Ultrasound (US) is the gold standard for evaluation of pelvic organs; however, achieving a full bladder can be challenging for children. Recent studies have shown excellent diagnostic performance of rapid MRI for acute appendicitis. As MRI becomes more prevalent in the evaluation of right lower quadrant pain, its use for gynecologic indications should be reevaluated.</div></div><div><h3>Methods</h3><div>A retrospective review of patients who had rapid MRI examinations performed in the emergency department (ED) for right lower quadrant pain at a single institution was conducted from August 2022 through August 2023. A time-matched control group with US evaluation for the same indication was obtained. A rapid, non-contrast three-sequence free-breathing MRI protocol was utilized.</div></div><div><h3>Results</h3><div>Of the 376 rapid MRI exams performed for the indication of right lower quadrant pain, 49 were noted to have gynecologic pathology identified. Of the 250 time-matched US controls, 51 were noted to have gynecologic pathology. The median MRI scan time (first image to last image) was 10 minutes. The total length of stay in the ED was significantly shorter in the rapid MRI group than in the controls (median 338 minutes vs 442 minutes, <em>P</em> < .05). Time to imaging diagnosis was significantly shorter in the rapid MRI group (201 minutes vs 285 minutes, <em>P</em> < .01). Time to gynecology consultation was not significantly different between groups (238 minutes vs 253 minutes, <em>P</em> = .66).</div></div><div><h3>Conclusion</h3><div>First-line, rapid MRI for evaluation of gynecologic processes can provide imaging diagnoses faster than using US and results in lower overall lengths of stay in the ED.</div></div>","PeriodicalId":16708,"journal":{"name":"Journal of pediatric and adolescent gynecology","volume":"38 6","pages":"Pages 717-723"},"PeriodicalIF":1.8,"publicationDate":"2025-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144659492","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-07-10DOI: 10.1016/j.jpag.2025.04.001
Neville H. Golden MD
{"title":"Exogenous Hormones and Bone Health in Adolescent Girls","authors":"Neville H. Golden MD","doi":"10.1016/j.jpag.2025.04.001","DOIUrl":"10.1016/j.jpag.2025.04.001","url":null,"abstract":"","PeriodicalId":16708,"journal":{"name":"Journal of pediatric and adolescent gynecology","volume":"38 4","pages":"Pages 445-446"},"PeriodicalIF":1.7,"publicationDate":"2025-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144589018","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-07-10DOI: 10.1016/j.jpag.2025.03.002
Eveline J Roos MD, MSc
{"title":"The Importance of Bladder Health Knowledge in the Female Pediatric and Adolescent Population—A Role for the PAG Provider?","authors":"Eveline J Roos MD, MSc","doi":"10.1016/j.jpag.2025.03.002","DOIUrl":"10.1016/j.jpag.2025.03.002","url":null,"abstract":"","PeriodicalId":16708,"journal":{"name":"Journal of pediatric and adolescent gynecology","volume":"38 4","pages":"Pages 447-448"},"PeriodicalIF":1.7,"publicationDate":"2025-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144589019","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-07-10DOI: 10.1016/j.jpag.2025.02.008
Blair Lacy MD , Amanda French MD , Sloane Berger-Chen MD , Mila Shah-Bruce MD , Fareeda Haamid MD
Heavy menstrual bleeding is a common condition encountered in the adolescent patient population. The objective of this consensus guideline is to provide the latest evidence regarding the use of tranexamic acid as a treatment modality for heavy menstrual bleeding in this age group.
Methods
A PubMed search was completed on December 5, 2024 for all articles published since 1970 using (tranexamic acid or “tranexamic acid” or “TXA”) and (menorrhagia or “heavy menstrual bleeding”) and (“adolescent” or “teenager” or “teen” or “pediatric”). A second search using (tranexamic acid or “tranexamic acid” or “TXA”) AND (menorrhagia or “heavy menstrual bleeding”) was done using PubMed, the Cochrane Database of Systematic Reviews, and the Cochrane Library.
{"title":"NASPAG Clinical Consensus: Use of Tranexamic Acid in the Treatment of Heavy Menstrual Bleeding","authors":"Blair Lacy MD , Amanda French MD , Sloane Berger-Chen MD , Mila Shah-Bruce MD , Fareeda Haamid MD","doi":"10.1016/j.jpag.2025.02.008","DOIUrl":"10.1016/j.jpag.2025.02.008","url":null,"abstract":"<div><div>Heavy menstrual bleeding is a common condition encountered in the adolescent patient population. The objective of this consensus guideline is to provide the latest evidence regarding the use of tranexamic acid as a treatment modality for heavy menstrual bleeding in this age group.</div></div><div><h3>Methods</h3><div>A PubMed search was completed on December 5, 2024 for all articles published since 1970 using (tranexamic acid or “tranexamic acid” or “TXA”) and (menorrhagia or “heavy menstrual bleeding”) and (“adolescent” or “teenager” or “teen” or “pediatric”). A second search using (tranexamic acid or “tranexamic acid” or “TXA”) AND (menorrhagia or “heavy menstrual bleeding”) was done using PubMed, the Cochrane Database of Systematic Reviews, and the Cochrane Library.</div></div>","PeriodicalId":16708,"journal":{"name":"Journal of pediatric and adolescent gynecology","volume":"38 4","pages":"Pages 452-457"},"PeriodicalIF":1.7,"publicationDate":"2025-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144589020","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Female genital mutilation/cutting (FGM/C) is a global problem affecting millions of girls and women. It involves cutting or removing parts of the external genitalia for no medical reason, often without consent, and has no health benefits. It is deeply rooted in tradition and often undertaken by lay practitioners. It is known to have immediate risks (of hemorrhage, infection, death) and long-term sexual, gynecological, obstetric, urological, and mental health sequelae including post-traumatic stress disorder. Health professionals worldwide need to be aware that girls and women from high-prevalence regions, including migrants, might have been subjected to FGM/C. FIGIJ and NASPAG strongly oppose the harmful practice of FGM/C as it is a form of gender-based violence and child abuse. FIGIJ and NASPAG call upon governments to ban the practice, and health professionals to develop culturally sensitive patient-centered clinical practice guidelines, and to respectfully cooperate with community leaders in order to co-design solutions that will eliminate the practice.
{"title":"FIGIJ Advocacy Statement on Female Genital Mutilation/Cutting FGM/C, Endorsed by NASPAG","authors":"Anastasia Vatopoulou MD, PhD , Judith Simms-Cendan MD , Daniela Ivanova Panova MD, PhD , Clara Di Nunzio MD , Mariela Orti MD , Ellen Rome MD, MPH , Angela Aguilar MD, MSc, MBA , Michalina Drejza MD, MSc, PhD , Marisa Labovsky MD , Yasmin Jayasinghe MBBS, PhD","doi":"10.1016/j.jpag.2025.06.009","DOIUrl":"10.1016/j.jpag.2025.06.009","url":null,"abstract":"<div><div>Female genital mutilation/cutting (FGM/C) is a global problem affecting millions of girls and women. It involves cutting or removing parts of the external genitalia for no medical reason, often without consent, and has no health benefits. It is deeply rooted in tradition and often undertaken by lay practitioners. It is known to have immediate risks (of hemorrhage, infection, death) and long-term sexual, gynecological, obstetric, urological, and mental health sequelae including post-traumatic stress disorder. Health professionals worldwide need to be aware that girls and women from high-prevalence regions, including migrants, might have been subjected to FGM/C. FIGIJ and NASPAG strongly oppose the harmful practice of FGM/C as it is a form of gender-based violence and child abuse. FIGIJ and NASPAG call upon governments to ban the practice, and health professionals to develop culturally sensitive patient-centered clinical practice guidelines, and to respectfully cooperate with community leaders in order to co-design solutions that will eliminate the practice.</div></div>","PeriodicalId":16708,"journal":{"name":"Journal of pediatric and adolescent gynecology","volume":"38 6","pages":"Pages 649-652"},"PeriodicalIF":1.8,"publicationDate":"2025-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144618678","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-07-04DOI: 10.1016/j.jpag.2025.06.011
Elaine M.C. Maia PhD , Raquel A.C. Peixoto MD , Francisco H.C. Carvalho MD , Cristina A.F. Guazzelli MD
Study Objective
To assess contraceptive preferences, acceptance, continuity, and satisfaction with contraceptive use among postpartum adolescents who desired contraception in Fortaleza, Brazil.
Design
This prospective observational study included 166 postpartum adolescents (≤48 hours after delivery) at a public hospital in Brazil between November 2019 and March 2022. Participants were interviewed twice: before discharge (in person) and 6 months after delivery (via telephone). Pearson’s chi-squared and Fisher’s exact tests assessed associations between categorical variables and satisfaction with long-acting contraceptives (LARCs). Logistic regression identified factors influencing early contraception initiation.
Results
The most preferred methods in the immediate postpartum period were implants (45.8%), intrauterine devices (IUDs) (34.3%), injectables (16.3%), and pills (3.0%). Nearly half (47.6%) initiated LARCs before discharge. Six months postdelivery, 81.3% were using a contraceptive method. Among implant users, continuity was 100%, and for IUDs initiated before discharge, 70%. A higher satisfaction level was observed in LARC users compared to non-LARC users.
Conclusion
The postpartum period is an ideal time to offer safe contraceptive options. LARC methods, particularly implants and IUDs, are highly valued by adolescents, showing high satisfaction and continuity rates.
{"title":"Adolescents’ Contraceptive Choice in the Immediate Postpartum Period: A Cohort Study","authors":"Elaine M.C. Maia PhD , Raquel A.C. Peixoto MD , Francisco H.C. Carvalho MD , Cristina A.F. Guazzelli MD","doi":"10.1016/j.jpag.2025.06.011","DOIUrl":"10.1016/j.jpag.2025.06.011","url":null,"abstract":"<div><h3>Study Objective</h3><div>To assess contraceptive preferences, acceptance, continuity, and satisfaction with contraceptive use among postpartum adolescents who desired contraception in Fortaleza, Brazil.</div></div><div><h3>Design</h3><div>This prospective observational study included 166 postpartum adolescents (≤48 hours after delivery) at a public hospital in Brazil between November 2019 and March 2022. Participants were interviewed twice: before discharge (in person) and 6 months after delivery (via telephone). Pearson’s chi-squared and Fisher’s exact tests assessed associations between categorical variables and satisfaction with long-acting contraceptives (LARCs). Logistic regression identified factors influencing early contraception initiation.</div></div><div><h3>Results</h3><div>The most preferred methods in the immediate postpartum period were implants (45.8%), intrauterine devices (IUDs) (34.3%), injectables (16.3%), and pills (3.0%). Nearly half (47.6%) initiated LARCs before discharge. Six months postdelivery, 81.3% were using a contraceptive method. Among implant users, continuity was 100%, and for IUDs initiated before discharge, 70%. A higher satisfaction level was observed in LARC users compared to non-LARC users.</div></div><div><h3>Conclusion</h3><div>The postpartum period is an ideal time to offer safe contraceptive options. LARC methods, particularly implants and IUDs, are highly valued by adolescents, showing high satisfaction and continuity rates.</div></div>","PeriodicalId":16708,"journal":{"name":"Journal of pediatric and adolescent gynecology","volume":"38 6","pages":"Pages 712-716"},"PeriodicalIF":1.8,"publicationDate":"2025-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144575718","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-07-04DOI: 10.1016/j.jpag.2025.06.008
Megan N. Parker PhD , Shelby P. Wiggins MD , Jennifer A. Thornton PhD , Kevin W. Sunderland PhD , Rick Brydum , Wendy Funk MS , Veronika Pav MS , David A. Klein MD, MPH
Study Objective
Polycystic ovary syndrome (PCOS) is the most common endocrine disorder among people who menstruate. Adolescent and young adult (AYA) military dependents, a large, diverse subset of the United States population, have not been represented in prior reports of PCOS. This study estimated the incidence and prevalence of possible-PCOS (PCOS symptoms in the absence of a documented PCOS diagnosis) and PCOS in AYA military dependents, and described the length of time between possible-PCOS and first documented PCOS diagnosis for people who met both during the surveillance period.
Methods
This retrospective cohort study reviewed military electronic medical records and TRICARE insurance claims from the US Military Health System from 2018 to 2022. We identified female dependents aged 15-21 years with PCOS (International Classification of Diseases, 10th edition (ICD-10); code E28.2x) or possible-PCOS (i.e., having both androgen excess and a amenorrhea or oligomenorrhea ICD-10 code within a 12-month period) who received care through TRICARE due to insurance sponsor’s military service.
Results
A total of 8385 AYA military dependents had PCOS or possible-PCOS. Across the 5-year period, the average yearly incidence was 59/10,000 people (range 54-64). The average yearly prevalence was 182/10,000 people (range 159-195) and was lowest among Black (139/10,000 people) and Asian (132/10,000 people) AYA.
Conclusion
Rates of PCOS in AYA military dependents are comparable to rates estimated from medical record data in US civilian populations. Identifying barriers to PCOS detection could facilitate earlier treatment access for military dependents.
{"title":"Incidence and Prevalence of Polycystic Ovary Syndrome in Adolescent and Young Adult US Military Dependents From 2018 to 2022","authors":"Megan N. Parker PhD , Shelby P. Wiggins MD , Jennifer A. Thornton PhD , Kevin W. Sunderland PhD , Rick Brydum , Wendy Funk MS , Veronika Pav MS , David A. Klein MD, MPH","doi":"10.1016/j.jpag.2025.06.008","DOIUrl":"10.1016/j.jpag.2025.06.008","url":null,"abstract":"<div><h3>Study Objective</h3><div>Polycystic ovary syndrome (PCOS) is the most common endocrine disorder among people who menstruate. Adolescent and young adult (AYA) military dependents, a large, diverse subset of the United States population, have not been represented in prior reports of PCOS. This study estimated the incidence and prevalence of possible-PCOS (PCOS symptoms in the absence of a documented PCOS diagnosis) and PCOS in AYA military dependents, and described the length of time between possible-PCOS and first documented PCOS diagnosis for people who met both during the surveillance period.</div></div><div><h3>Methods</h3><div>This retrospective cohort study reviewed military electronic medical records and TRICARE insurance claims from the US Military Health System from 2018 to 2022. We identified female dependents aged 15-21 years with PCOS (International Classification of Diseases, 10<sup>th</sup> edition (ICD-10); code E28.2x) or possible-PCOS (i.e., having both androgen excess and a amenorrhea or oligomenorrhea ICD-10 code within a 12-month period) who received care through TRICARE due to insurance sponsor’s military service.</div></div><div><h3>Results</h3><div>A total of 8385 AYA military dependents had PCOS or possible-PCOS. Across the 5-year period, the average yearly incidence was 59/10,000 people (range 54-64). The average yearly prevalence was 182/10,000 people (range 159-195) and was lowest among Black (139/10,000 people) and Asian (132/10,000 people) AYA.</div></div><div><h3>Conclusion</h3><div>Rates of PCOS in AYA military dependents are comparable to rates estimated from medical record data in US civilian populations. Identifying barriers to PCOS detection could facilitate earlier treatment access for military dependents.</div></div>","PeriodicalId":16708,"journal":{"name":"Journal of pediatric and adolescent gynecology","volume":"38 6","pages":"Pages 693-699"},"PeriodicalIF":1.8,"publicationDate":"2025-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144567563","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
The binding of the SARS-CoV-2 spike protein from vaccination can affect the menstrual cycle. Most studies have focused on women of reproductive age, with less attention given to adolescent and young women, despite their increased risk of heightened responses to vaccines. Thus, we consolidated evidence on menstrual changes after COVID-19 vaccination for adolescent and young women.
Methods
The OVID MEDLINE, EMBASE, and CINAHL databases were searched (January 2020-December 2024) for peer-reviewed studies on COVID-19 vaccination in menstruating people <25 years old. Of 80 articles identified, 15 met the inclusion criteria after review by 2 independent reviewers. We estimated risk ratios (RRs) and mean differences (MDs) when data permitted. We assessed publication bias with funnel plots and evaluated heterogeneity using Cochran’s Q, Galbraith plots, and the I² statistic. Outcomes included any measured or perceived changes in menstrual cycles, bleeding length, and cycle length (ie, length between the first day of bleeding of 2 periods).
Results
Among the 15 studies, 24,647 adolescents and young adults aged 12-25 were included. The summary effect measure showed no effect of vaccination on any menstrual change (RR = 1.09; 95% CI, 0.84-1.42) and significant heterogeneity across studies (I2 = 69%). There was, however, a greater risk of longer cycle length after vaccination (RR = 1.17; 95% CI, 1.08-1.27) and no heterogeneity between 2 studies (I2 = 0%); however, when assessed continuously, there was a nonsignificant increase in cycle length (MD = 0.24 days; 95% CI, –0.34 to 0.82). No studies assessed menses bleeding length in adolescent and young women. Funnel plots suggested no publication bias.
Conclusion
Although few studies were included, the available data suggest that there may be an increased risk of a longer menstrual cycle length in adolescents and young women, but no other changes were identified. Further data are needed.
{"title":"The Effect of COVID-19 Vaccination on Menstrual Cycles of Adolescents and Young Adults: A Systematic Review and Meta-analysis","authors":"B.M. Milne MPH, PhD(c) , E.M. Mallett BScH , S.B. Brogly PhD","doi":"10.1016/j.jpag.2025.06.010","DOIUrl":"10.1016/j.jpag.2025.06.010","url":null,"abstract":"<div><h3>Background and Study Objective</h3><div>The binding of the SARS-CoV-2 spike protein from vaccination can affect the menstrual cycle. Most studies have focused on women of reproductive age, with less attention given to adolescent and young women, despite their increased risk of heightened responses to vaccines. Thus, we consolidated evidence on menstrual changes after COVID-19 vaccination for adolescent and young women.</div></div><div><h3>Methods</h3><div>The OVID MEDLINE, EMBASE, and CINAHL databases were searched (January 2020-December 2024) for peer-reviewed studies on COVID-19 vaccination in menstruating people <25 years old. Of 80 articles identified, 15 met the inclusion criteria after review by 2 independent reviewers. We estimated risk ratios (RRs) and mean differences (MDs) when data permitted. We assessed publication bias with funnel plots and evaluated heterogeneity using Cochran’s Q, Galbraith plots, and the <em>I</em>² statistic. Outcomes included any measured or perceived changes in menstrual cycles, bleeding length, and cycle length (ie, length between the first day of bleeding of 2 periods).</div></div><div><h3>Results</h3><div>Among the 15 studies, 24,647 adolescents and young adults aged 12-25 were included. The summary effect measure showed no effect of vaccination on any menstrual change (RR = 1.09; 95% CI, 0.84-1.42) and significant heterogeneity across studies (<em>I</em><sup>2</sup> = 69%). There was, however, a greater risk of longer cycle length after vaccination (RR = 1.17; 95% CI, 1.08-1.27) and no heterogeneity between 2 studies (<em>I</em><sup>2</sup> = 0%); however, when assessed continuously, there was a nonsignificant increase in cycle length (MD = 0.24 days; 95% CI, –0.34 to 0.82). No studies assessed menses bleeding length in adolescent and young women. Funnel plots suggested no publication bias.</div></div><div><h3>Conclusion</h3><div>Although few studies were included, the available data suggest that there may be an increased risk of a longer menstrual cycle length in adolescents and young women, but no other changes were identified. Further data are needed.</div></div>","PeriodicalId":16708,"journal":{"name":"Journal of pediatric and adolescent gynecology","volume":"38 6","pages":"Pages 653-660"},"PeriodicalIF":1.8,"publicationDate":"2025-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144567564","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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